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In the present study, we compared the diagnostic accuracy of cardiovascular magnetic resonance (CMR)-based T1-mapping and subsequent extracellular volume fraction (ECV) measurement and longitudinal strain analysis in the same patients with (a) biopsy-proven cardiac amyloidosis (CA) and (b) hypertrophic cardiomyopathy (HCM). <jats:italic>N<\/jats:italic>\u2009=\u200930 patients with CA, <jats:italic>N<\/jats:italic>\u2009=\u200920 patients with HCM and <jats:italic>N<\/jats:italic>\u2009=\u200915 healthy control patients without relevant cardiac disease underwent dedicated CMR studies. The CMR protocol included standard sequences for cine-imaging, native and post-contrast T1-mapping and late-gadolinium-enhancement. ECV measurements were based on pre- and post-contrast T1-mapping images. Feature-tracking analysis was used to calculate 3D left ventricular longitudinal strain (LV-LS) in basal, mid and apical short-axis cine-images and to assess the presence of relative apical sparing. Receiver-operating-characteristic analysis revealed an area-under-the-curve regarding the differentiation of CA from HCM of 0.984 for native T1-mapping (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), of 0.985 for ECV (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and only 0.740 for the \u201capical-to-(basal\u2009+\u2009midventricular)\u201d-ratio of LV-LS (<jats:italic>p<\/jats:italic>\u2009=\u20090.012). A multivariable logistical regression analysis showed that ECV was the only statistically significant predictor of CA when compared to the parameter LV-LS or to the parameter \u201capical-to-(basal\u2009+\u2009midventricular)\u201d LV-RLS-ratio. Native T1-mapping and ECV measurement are both superior to longitudinal strain measurement (with assessment of relative apical sparing) regarding the appropriate diagnosis of CA.<\/jats:p>","DOI":"10.1038\/s41598-021-94650-2","type":"journal-article","created":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T10:04:43Z","timestamp":1627639483000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["CMR-based T1-mapping offers superior diagnostic value compared to longitudinal strain-based assessment of relative apical sparing in cardiac amyloidosis"],"prefix":"10.1038","volume":"11","author":[{"given":"Dennis","family":"Korthals","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grigorios","family":"Chatzantonis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Bietenbeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Meier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Stalling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Yilmaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,30]]},"reference":[{"issue":"10","key":"94650_CR1","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1056\/NEJM196709072771006","volume":"277","author":"AS Cohen","year":"1967","unstructured":"Cohen, A. 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